Endoscopic Findings of Upper Gastrointestinal Involvement in Primary Vasculitis

Autor: Eun Jeong Gong, Do Hoon Kim, Joo Hyun Chun, Ji Yong Ahn, Kwi-Sook Choi, Kee Wook Jung, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin Ho Kim, In Hye Song, Yong-Gil Kim
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Gut and Liver, Vol 10, Iss 4, Pp 542-548 (2016)
Druh dokumentu: article
ISSN: 1976-2283
DOI: 10.5009/gnl15198
Popis: Background/AimsGastrointestinal involvement in vasculitis may result in life-threatening complications. However, its variable clinical presentations and endoscopic features, and the rarity of the disease, often result in delayed diagnosis.Methods : Clinical characteristics, endoscopic features, and histopathological findings were reviewed from medical records.Results : Of 6,477 patients with vasculitis, 148 were diagnosed as primary vasculitis with upper gastrointestinal involvement. Of these, 21 cases (14.2%) were classified as large-vessel vasculitis, 17 cases (11.5%) as medium-vessel vasculitis, and 110 cases (74.3%) as small-vessel vasculitis. According to the specific diagnosis, IgA vasculitis (Henoch-Schönlein purpura) was the most common diagnosis (56.8%), followed by Takayasu arteritis (14.1%), microscopic polyangiitis (10.1%), and polyarteritis nodosa (6.8%). Gastrointestinal symptoms were present in 113 subjects (76.4%), with abdominal pain (78.8%) the most common symptom. Erosion and ulcers were striking endoscopic features, and the second portion of the duodenum was the most frequently involved site. Biopsy specimens were obtained from 124 patients, and only eight (5.4%) presented histopathological signs of vasculitis.Conclusion : sDiagnosis of vasculitis involving the upper gastrointestinal tract is difficult. Because of the widespread use of endoscopy, combining clinical features with endoscopic findings may facilitate making appropriate diagnoses; however, the diagnostic yield of endoscopic biopsy is low.
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